J.Jpn. Surg. Soc.. 58(7): 1097-1110, 1957
ON THE OPERATIVE INDICATION OF INFLAMMATION OF THE BILE DUCT FROM THE VIEW POINT OF STUDY OF BILE OBTAINED BY PERCUTANEOUS PUNCTURE
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1st Department of Surgery, Chiba University School of Medicine (Director: Rrof. Naoji KAWAI) Taminosuke SHIMIZU |
At first, the micro-organisms in bile of the gall bladder which is obtained by percutaneous puncture were studied. Especially, morphological study of the micro-organisms was performed optically and electron-microscopically. When many atypical micro-organisms were found, inflammation mostly disappeared and it is the most suitable stage of operation. This stage might be clinically about 3 weeks after the last pain attack.
Amount of bilirubin in bile of the gall bladder which is obtained by percutaneous puncture and B. bile was measured. When there was a marked difference between them, disturbance of bile duct passage was suspected and indication of choledochotomy was more clearly defined referring to the result of percutaneous choledochography.
Besides, bile of the gall bladder which was obtained by percutaneously was dried on a watch glass under constant temperature, and crystal of the bile was examined macroscopically and optico-microscopically. When a fernshaped crystal was observed, formation of gallstone could be easily diagnosed.
In short, according to the results of examinations of micro-organisms, amount of bilirubin, crystallization of bile of the gall bladder which is obtained percutaneously, more excellent diagnosis and operative indication of inflammation of the bile duct can be determined.
(author's abstract)
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